FTC Mandated to Investigate PBM Drug Pricing, Steering Practices, with Initial Report Due in Six Months

The “Prescription Pricing for the People Act of 2025” is essentially Congress telling the Federal Trade Commission (FTC) to go deep undercover on the pharmaceutical supply chain, specifically targeting the middlemen known as Pharmacy Benefit Managers (PBMs). This isn't just a casual look; the FTC has a hard deadline—one year—to deliver a comprehensive report to Congress detailing if PBMs are playing fair. The core mission is transparency and competition, and the law demands an initial progress report within 180 days of enactment. This bill is a direct response to the persistent, nagging question of why prescription drugs cost so much, and it puts the spotlight squarely on the entities that sit between the drug manufacturer and the patient.

The PBM Deep Dive: Who’s Steering the Ship?

If you’ve ever wondered why your insurance plan pushes you toward a specific mail-order pharmacy or why a cheaper generic isn't covered, this bill is trying to get answers. Section 3 mandates the FTC to investigate several key areas of PBM operation that hit everyday consumers and local pharmacies hard. For instance, the FTC must determine if PBMs charge clients (like your employer or insurer) more for a drug than they actually pay their own pharmacies for that same drug. This is called “spread pricing,” and it’s a classic example of self-dealing that can inflate costs for everyone.

They also have to check for “patient steering”—the practice where a PBM directs patients toward a pharmacy it owns, potentially limiting your choice of where you fill your prescription, even if a local pharmacy is cheaper or more convenient. Think about the small, independent pharmacy down the street: the FTC will examine whether PBMs are misusing their non-owned pharmacies’ proprietary data to unfairly boost their own market share. If you run a small business that pays for employee health insurance, or if you rely on specific medications, these practices directly affect your bottom line and your access to care.

Mergers, Monopolies, and the Cost of Doing Business

The bill isn't just about PBMs; it tackles the bigger picture of consolidation in healthcare. The FTC must look at how these intermediaries are merging with other parts of the supply chain—like insurance companies or suppliers—and whether these mergers actually benefit consumers through lower costs, as promised. The report needs to assess if the sheer complexity of contracting with these middlemen is worth the hassle and cost for payers. This section acknowledges a major problem: the drug market is so opaque that nobody outside the PBMs truly knows who is making money and where the costs are stacking up. For a busy professional, this means the bill is trying to peel back the layers of bureaucracy that contribute to your rising premiums and out-of-pocket costs.

Targeting the Sole-Source Drug Problem

Beyond the PBM study, Section 4 requires a separate, focused report on manufacturers of “sole-source drugs”—medications made by only one company. If you or a family member rely on a specific, life-saving drug with no generic equivalent, you know how vulnerable you are to price hikes. The FTC must count the complaints they’ve received about these manufacturers acting anticompetitively and, crucially, tell Congress if they currently have the legal authority to actually do anything about it. This is the FTC asking for a bigger stick, proposing new laws or policy changes to ensure that companies with a monopoly on a critical drug can’t exploit that position without consequence. This part of the bill could directly lead to stronger antitrust enforcement, which is good news for anyone dealing with high costs for specialized medications.